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Developments February 6 – 10: Is the Price Right?

During the week reviewed, no new bill was introduced which, if passed, would repeal or replace the Affordable Care Act, and little else happened at the three main ACA enforcement agencies – DOL, HHS and IRS. Department...more

2015 Form 1095-C Penalty Letters: Have You Got Mail?

Since late December, 2016, many Applicable Large Employer Members have received IRS Letter 5699 from a Tax Compliance Officer at an address in Florence, Kentucky. The “Dear Taxpayer” letter is headed: “Request for Employer...more

The End of the Beginning: Developments January 27 – February 5

Nothing resembling a repeal/replace consensus bill emerged from any committee in either chamber during the survey period. Instead, in a Fox News interview broadcast just before the Super Bowl, the President confessed that...more

Hitch In the Giddy-up: Round-up of Developments January 19 – 27

As previously reported, § 2001 of the 2017 budget bill required all ACA repeal/replace bills to be filed and reported from assigned committees by Friday, January 27, 2017. That didn’t happen. Since our last posting, the...more

President Trump’s First ACA “Executive Action”

Shortly after his January 20 inauguration, President Trump signed an Executive Order (promptly published by Politico) titled, “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Appeal.” ...more

On Your Mark, Get Ready, to Go . . . Somewhere: Congressional Developments January 12-18

On January 13, the House passed the 2017 budget resolution (S. Con. Res. 3), which should be found on President Trump’s desk Monday morning. As previously explained, this sets the stage for a filibuster-proof, budget...more

Fitness Enthusiasm Wanes Early: ACA-Related Congressional Actions January 5 – 12

On January 5, the House passed the “Regulations from the Executive in Need of Scrutiny Act of 2017” (H.R. 26), streamlining the process for Congressional review and rejection of administrative agency rules, including a...more

How’s This for a Dramatic Entrance?

As of Thursday morning, January 5, the general direction and pace of ACA repeal / replace legislation is discernible (details below), but the details are not. News reports suggest that, despite persisting, material...more

ACA Repeal Reality Check

We didn’t take ten weeks off because there was nothing to talk about. Rather, we concluded around Labor Day that anything useful to be said about ACA compliance, pre-election, would be interpreted as political advocacy, so...more

Draft IRS Publication 5164 (Early Look) for Processing Year 2017

If your EIN will have 250 or more full-time employees in 2016 (counting each person who was full-time in any month) you’ll need next year to file your 2016 ACA Information Returns – Forms 1094-B and 1095-B or Forms 1094-C and...more

2016 Draft Forms 1094-C and 1095-C and Instructions: What’s New, Page-by-Page

In the ACA realm, change is the only constant, so don’t take this to the bank. We’re telling you what we see for the first time, on a first reading of the draft 2016 Forms and Instructions that the IRS has released since...more

Stand Alone, Fixed-Indemnity Plans Are Back, Maybe

In Central United Life Ins. Co. v. Burwell, D.C. Cir. No. 15-5310 (July 1, 2016), a D.C. Circuit panel affirmed, 3-0, a trial court injunction barring enforcement of the 2014 HHS regulation permitting individual...more

ACA Retaliation: Let Us Tell You A Little Story about A Man Named Jed

Jed, employed by Drysdale LLC, a janitorial contractor, recently began working nights at the National Bank of Commerce, supervised by the Bank’s Chief of Security. Jed’s family had health insurance until his wife lost her...more

EEOC Sample Notice for Employer-Sponsored Wellness Programs

You know the drill. A manufacturer advertises a new drug, warning, of course, that some users may suffer serious side effects. A year or two later, lawyers counter-advertise for new clients with those conditions who took...more

2015 ACA Information Reporting: Parts Sold Separately, Some Assembly Required

Ten days before the deadline for electronic filing of 2015 Forms 1094-C and 1095-C, many employers are discovering that they contracted for less than all the needed services. Here’s what we’re seeing all too...more

House v. Burwell: Insurer Cost-Sharing Subsidies Unauthorized

A U.S. District Judge has ruled that HHS unlawfully has spent billions of dollars to reimburse insurers for cost-sharing reductions granted to individuals who bought health insurance through an ACA Exchange such as...more

So I Made This Little 1095-C Mistake. Big Deal?

The 2015 Instructions for Forms 1094-C and 1095-C tell Applicable Large Employers how to furnish and file corrections to incorrectly filed Forms 1095-C. ...more

Heffalumps, Woozles and Limited Non-Assessment Periods: Very Confusel

So, you were a 2015 Applicable Large Employer. You waited too late to outsource your generation, furnishing and filing of 2015 Forms 1095-C. Fortunately, you believe, you are permitted to file on paper, by May 31, 2016,...more

Code § 4980H: The Tax The Beatles Missed

The Tax Man, it turns out, also may assess you for failing to offer substantially all your full-time employees and their dependents affordable, qualifying group health coverage during 2015. We’re swamped with employer...more

Questionable Retaliation Theory Gets Traction

Since our earliest postings, we have warned of a notion, prevalent among employee counsel, that an employer plan sponsor unlawfully retaliates against an employee by reducing her work hours in order to deprive her of ACA...more

ACA Myths That Just Won’t Die

Lawyers, politicians, economists, climate scientists, fad diet peddlers . . . we all know that it’s child’s play to persuade people of what they want to believe. Perhaps that explains the persistence of so many...more

ACA Information Return Deadlines Extended

On December 28, 2105, the IRS released its Notice 2016-4, granting much needed time for employers and their filing services to catch up to Affordable Care Act Information Return (AIR) Program developments. ...more

Coming Down Your Chimney: Market Reform Guidance, Information Reporting Penalty Relief and Cadillac Tax Delay

It’s the “silly season” on the Hill and a busy season for ACA regulators. This article gives you brief notes about Notice 2015-87, information reporting relief and the § 4980I delay buried in the omnibus spending bill....more

Give Me Just A Little More Time . . .

Was the title of a 1970 soul hit for the Chairmen of the Board. Though your love for ACA information reporting is unlikely to grow as a result, you may need a little more time to get it done. This article responds to multiple...more

HHS 2017 Notice of Benefit and Payment Parameters

This is the annual hodge-podge of changes to the risk adjustment, reinsurance, and risk corridors programs, cost sharing parameters, cost-sharing reductions, and Healthcare.gov user fees, usually filling hundreds of Federal...more

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